Comparative analysis of Denosumab and Zoledronic acid in advanced breast cancer patients receiving CDK4/6 inhibitors
A comparative analysis of Denosumab (DMAB) and Zoledronic Acid (ZA) was conducted in a real-world cohort of 864 patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer with bone metastases, who were undergoing CDK4/6 inhibitors plus endocrine therapy. We evaluated the time to first skeletal-related events (SREs), progression-free survival (PFS), and overall survival (OS). To adjust for confounding variables, we utilized propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) methodologies. In the unadjusted cohort, ZA was associated with a longer time to first SRE compared to DMAB (HR = 0.77, 95 % CI: 0.61-0.98, p = 0.031). Similar results were obtained in both the PSM (HR = 0.69, 95 % CI: 0.52-0.92, p = 0.011) and IPTW cohorts (HR = 0.74, 95 % CI: 0.63-0.87, p < 0.001), with ZA-treated patients showing an extended time to first SRE compared to those treated with DMAB. No differences in PFS and OS were observed between the two cohorts.
Authors
- Elisa Tiberi
- Carmen Criscitiello (ORCID: https://orcid.org/0000-0001-9064-0113)
- Teresa Arcuri
- E. Speziale
- Giuseppe Curigliano (ORCID: https://orcid.org/0000-0003-1781-2518)
- Francesco Pantano (ORCID: https://orcid.org/0000-0002-2894-9686)
- Ornella Garrone (ORCID: https://orcid.org/0000-0001-7359-5410)
- Angela Toss (ORCID: https://orcid.org/0000-0002-1854-6701)
- Patrizia Vici (ORCID: https://orcid.org/0000-0001-7528-9783)
- Claudio Vernieri (ORCID: https://orcid.org/0000-0003-1577-8176)
- Lorena Filomeno (ORCID: https://orcid.org/0009-0002-6484-6833)
- Elisabetta Cretella (ORCID: https://orcid.org/0000-0001-8491-3058)
- Camillo Porta (ORCID: https://orcid.org/0000-0003-2412-1563)
- Rossana Berardi (ORCID: https://orcid.org/0000-0002-9529-2960)
- Michele Iuliani (ORCID: https://orcid.org/0000-0003-3536-7630)
- Stefania Gori (ORCID: https://orcid.org/0000-0001-6320-405X)
- Agnese Fabbri (ORCID: https://orcid.org/0000-0002-3357-6343)
- Michelino De Laurentiis (ORCID: https://orcid.org/0000-0001-9009-1572)
- Andrea Botticelli (ORCID: https://orcid.org/0000-0002-6425-9893)
- Orazio Caffo
- Silvia Cavaliere
- Simona Pisegna (ORCID: https://orcid.org/0000-0002-6910-9528)
- Cristina Fiore
- Simone Scagnoli (ORCID: https://orcid.org/0000-0003-4943-5622)
- Federica Villa (ORCID: https://orcid.org/0009-0005-5052-1079)
- Sara Ramella (ORCID: https://orcid.org/0000-0002-5782-7717)
- Azzurra Irelli (ORCID: https://orcid.org/0000-0003-4724-6297)
- Luca Visani (ORCID: https://orcid.org/0000-0002-7079-231X)
- Maria Grazia Rossino
- Giampaolo Bianchini (ORCID: https://orcid.org/0000-0002-6790-6267)
- Niccolò Bertini (ORCID: https://orcid.org/0009-0006-1053-6265)
- Michela Palleschi (ORCID: https://orcid.org/0000-0003-2623-4705)
- Annarita Verrazzo (ORCID: https://orcid.org/0009-0007-0974-3635)
- Caterina Sposetti (ORCID: https://orcid.org/0000-0003-3211-8516)
- Sonia Simonetti (ORCID: https://orcid.org/0000-0002-0673-1272)
- Francesca Sofia Di Lisa
- Claudia Piombino (ORCID: https://orcid.org/0000-0002-7224-4536)
- Giuseppe Tonini (ORCID: https://orcid.org/0000-0003-4442-8677)
- Marco Mazzotta (ORCID: https://orcid.org/0000-0002-5478-9831)
- Alessio Cortellini (ORCID: https://orcid.org/0000-0002-1209-5735)
- Paolo Orsaria (ORCID: https://orcid.org/0000-0002-6224-7784)
- Raffaele Troiano (ORCID: https://orcid.org/0000-0002-1578-5694)
- Francesca Puce
- Edy Ippolito
- Giuliana D’Auria (ORCID: https://orcid.org/0000-0003-0500-0467)
- Marianna Sirico (ORCID: https://orcid.org/0000-0002-2536-3858)
- Barbara Tagliaferri (ORCID: https://orcid.org/0000-0002-4889-5574)
- Ugo De Giorgi (ORCID: https://orcid.org/0000-0001-7520-2908)
- Roberta Scafetta
- Bruno Vincenzi (ORCID: https://orcid.org/0000-0001-8222-9025)
- Luigia Stefania Stucci (ORCID: https://orcid.org/0000-0003-2063-1435)
- Alfredo Guarino (ORCID: https://orcid.org/0000-0003-0199-0336)
- Ilaria Bonaparte
- Ilaria Portarena
- Federica Domati
- Matteo Vergati
- Chiara Gullotta (ORCID: https://orcid.org/0000-0002-9201-8659)
- Simone Foderaro (ORCID: https://orcid.org/0000-0001-5864-0180)
- Marco Donato (ORCID: https://orcid.org/0000-0001-7126-3543)
- Daniele Santini (ORCID: https://orcid.org/0000-0002-9118-3337)
- V. Ricozzi
- L. Sisca
- Federica Riva (ORCID: https://orcid.org/0000-0002-7245-2386)
- Icro Meattini
- Luigi Rossi
- Roberta Caputo (ORCID: https://orcid.org/0000-0003-4231-1184)
- Mauro Minelli
- Delia De Lisi
- Marta Piras
- Rebecca Pedersini
Institutions
- Marche Polytechnic University (IT)
- Vita-Salute San Raffaele University (IT)
- Università Campus Bio-Medico (IT)
- Policlinico Umberto I (IT)
- Ospedale Santa Chiara (IT)
- Ospedale di Bolzano (IT)
- Istituti Clinici Scientifici Maugeri (IT)
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IT)
- Ospedale Sacro Cuore Don Calabria (IT)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Ospedale Sandro Pertini (IT)
- Policlinico Tor Vergata (IT)
- Campus Bio Medico University Hospital (IT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- Sapienza University of Rome (IT)
Publication Details
- Journal
- The Breast
- Published
- 2025-05-15
- DOI
- https://doi.org/10.1016/j.breast.2025.104502
- Citations
- 3
- Primary Topic
- Advanced Breast Cancer Therapies
- Type
- article
- Field-Weighted Citation Impact
- 4.56